Role of propranolol in the treatment of migraine

Prophylactic drugs are used by migraineurs. The most commonly recommended prophylactic drugs are the betablockers.
Among the different betablockers,
propranolol is one of the most commonly prescribed for migraine prophylaxis. It is not
known how betablockers
decrease the frequency of migraine attacks, but it is thought that it may affect the brain
serotonin receptors. Previously it has been demonstrated that the activation of serotonin receptors leds to the blockade of
CGRP liberation.
We hope to determine the role of propranolol in the prophylaxis of migraine by measuring with a laser Doppler scanner
the increase in dermal blood flow (DBF) after stimulation of the afferent nerves of the trigeminal nerve on the forehead.
The trigeminal nerve has also innervations to the dura mater, which is thought to be involved in the origin of migraine.
In order to accomplish that, the trigeminal afferent nerves will be stimulated by topical application of capsaicin and
electrical stimulation. Both stimuli lead to the release of CGRP, a vasodilator neuropeptide. We have the hypothesis, that
in migraine patients, the use of propranolol may modify the release of this neuropeptide. We will investigate this
hypothesis with the above mentioned model. First we will perform a study with healthy volunteers and in future, we hope
to perform in migraine patients with an effective prophylactic response and with an absent prophylactic response to
propranolol.
This study will provide more insight in the mechanism of action of propranolol and possibly in the pathophysiology of
migraine, which hopefully will also shed light on therapeutic targets and improved migraine treatment .

Reduced dermal blood flow response to capsaicin application and saline iontophoresis after propranolol ocompared to placebo administration.

subject have to come twice to the Erasmus MC, with a time interval of 1 till 2 weeks

Administration of propranolol